Provider Demographics
NPI:1225734338
Name:MATTHEW ADAMO, DMD
Entity Type:Organization
Organization Name:MATTHEW ADAMO, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:951-296-0705
Mailing Address - Street 1:41593 WINCHESTER RD STE 216
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4841
Mailing Address - Country:US
Mailing Address - Phone:951-296-0705
Mailing Address - Fax:
Practice Address - Street 1:41593 WINCHESTER RD STE 216
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4841
Practice Address - Country:US
Practice Address - Phone:951-296-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental